Sports-related concussion damage may persist long after return to play, study finds
After suffering a concussion, athletes may be returning to the game too quickly, as passing a clinical assessment may not be sufficient to determine whether the brain has returned to a pre-injury baseline. The findings come from a study published in Neurology. [1]
Researchers from the University of Toronto and Unity Health Toronto assessed whether concussed individuals show functional and structural brain changes, as seen on MRI. Specifically, they looked at post-concussion changes in cerebral blood flow and white matter, comparing images to pre-injury levels up to one year after the sports-related head injury occurred.
For their study, the team collected MRI data from 187 healthy university athletes, all without a history of psychiatric or neurological conditions, to develop a baseline. Athletes who suffered a concussion were given MRIs at various intervals after the injury, ranging from a few days after the injury, immediately after they returned to the sport, at one to three months post-return and then again one year after return to play.
The results were then compared with a control group of participants who did not suffer a concussion during play, with focus given to white matter mean diffusivity, fractional anisotropy and cerebral blood flow. The final analysis included 25 athletes with concussions, with an average age of 20 years (56% male and 44% female), compared with 27 control subjects of the same demographic makeup.
Despite receiving medical clearance for return to play, the athletes appeared unready for more sports just yet, the study authors, led by Nathan Churchill, PhD, of Unity Health in Toronto, concluded. After review, concussed athletes showed signs of brain damage long after passing a clinical assessment that allowed them to resume activity in contact sports.
Changes seen on MRI include reduced blood flow in the brain, diminished white matter diffusivity and reduced fractional anisotropy. Much of the damage was still apparent a year after returning to the field.
“The presence of significant, long-lasting brain changes after injury reinforces concerns about the consequences of repeated concussions and to what extent these effects accumulate over time,” Churchill et al. wrote.
As time went on, cerebral blood flow measurably improved in concussed athletes, suggesting that longer rest after cranial injury may improve brain recovery.
For more, read the full study at the link below.
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